ASOC Membership for Period 1 May 2019 to 30 June 2020

Form for new members to join & existing members to renew their membership

Member's Name:*
ASOC Membership Number (if known)
Home Phone:
Work Phone:
Mobile Phone:
I wish to receive the ASOC Newsletter By:*

Please select type of membership

Please select type of membership:*

New Members - please complete the fields in this section

Previous Involvement in Art:
Preferred Medium & Style:
Tell Us Something About Yourself:
How did you find out about ASOC:

Payment Details

Payment Total:
I am paying by:*


Pay to Artists Society of Canberra, BSB 633 000, Account Number 163574684, indicating ‘your family name CP entry'. Please email a copy of your receipt to mailto:

Date of EFT Payment

Credit Card

Pls indicate below what type of card you are using.

Type of Card:
Credit Card Number
Name on Card:
Expiry Date: mm/yy

Cheque Payment

- payable to ASOC

Bank Cheque Drawn From:
Date of Cheque: